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Having Diabetes, Managing Cholesterol

separator Maintaining healthy cholesterol levels is something everybody should think about. But people with diabetes need to give cholesterol management extra consideration. Why? Because simply having diabetes can affect the balance between the two types of cholesterol—HDL (the “good” kind) and LDL (the “bad” kind). That balance is crucial for a healthy cardiovascular system.

Ideally, you want to have more HDL and less LDL cholesterol in your blood. The LDL cholesterol is what causes fat to build up in the arteries. Too much of a buildup makes the arteries rigid and not flexible. That’s where the term “hardening of the arteries” comes from. Arteries need to be flexible to allow blood to flow easily through them to the heart.

The HDL cholesterol, on the other hand, carries away some of the bad cholesterol that’s been stored in the arteries. That’s why you want to have more of it, and less LDL.

How does diabetes affect cholesterol?

Having diabetes, and especially having higher levels of blood sugar, is enough to put you in a higher risk category for heart disease. Why?

  • For people with diabetes, there’s a greater likelihood that LDL cholesterol particles will stick to the arteries and damage their walls
  • Blood sugar, which is often higher in people with diabetes, coats the LDL particles and causes them to remain in the blood stream longer
  • People with diabetes are more likely to have lower HDL levels. In other words, there’s less of the good cholesterol to help remove the bad kind. And people with diabetes also are more likely to have higher levels of another type of fat, called triglycerides, in their blood.

New cholesterol guidelines may affect you
This summer, the National Heart, Lung, and Blood Association (NHLBI) revised its cholesterol guidelines. For people who have diabetes or heart disease, or who smoke and have high blood pressure, the NHLBI has lowered the target levels of LDL from 100 mg/dL to 70.

What can you do to make sure your levels are in the healthy range?
Visit your doctor to have your cholesterol checked if you haven’t done so lately. If your numbers are on target, then that’s good. If they’re not, talk with your doctor and a nutritionist, dietitian or diabetes educator to see what you can do to bring your numbers down. Diet, exercise, and medications play a key role. Take a look at the tips we offer in the next section of this magazine for some detailed suggestions about healthy cholesterol levels.

Taking care of cholesterol: one link in a large chain
Keeping your cholesterol in the healthy range is about so much more than simply the numbers. It’s also about helping lower your risk of heart attack and stroke. It’s about keeping your vascular system healthy, which in turn can help reduce such complications as foot ulcers.

Each component of diabetes care is an important link in a chain, so it’s important to do your best in all areas—healthy food, regular exercise, quitting smoking, routine medical visits, strict blood sugar control. It’s all interconnected.

And don’t forget to meet with your dietitian or diabetes educator at least once a year, even when things are going well. Your diabetes status changes over time, and it’s important to make adjustments along the way.

Diabetes Tips: Lowering Your Cholesterol Level
You have good intentions about keeping your cholesterol in the healthy range, but where do you start? The members of your healthcare team can make recommendations based on your specific situation, but the following tips are:

  • Limit foods containing saturated fat and trans fats. Your dietitian can help you create a plan that works well for you. It’s helpful to read food labels, because they’ll tell you how much saturated fat you’re getting. But trans fat quantities aren’t listed on the labels yet, and aren’t required to be until 2006. To figure out whether there are trans fats in any given food, look for the words “partially hydrogenated.” You’re likely to see these fats in most crackers, chips, cookies and other snack items. Trans fats are also common ingredients in deep fried foods, like French fries. The more you remove these foods from your diet, the better off you’ll be. (Be sure to check out the ratatouille recipe for a healthy vegetable dish that has no saturated or trans fats.)
  • Exercise regularly. Exercise can also help you control your blood sugar, because your body uses glucose to help your muscles move. Depending on the type of diabetes you have, regular exercise can reduce your daily insulin injection requirement, or it can help your body better regulate the use of its own insulin. In addition, exercise promotes weight loss, improves muscle tone, keeps your heart and lungs healthy and active and lowers blood cholesterol and triglyceride levels. If you are overweight, or don’t exercise regularly, it’s best to check with your healthcare provider before starting an exercise regimen. Keep in mind, the hardest part is getting started. Once you make exercise part of your routine, you will notice progress and have more energy in a very short time!
  • Take any medication your doctor has prescribed for you. Now that the NHLBI has revised its cholesterol guidelines, more people are candidates for cholesterol-lowering medications. Statins are the drug of choice for this. (Remember that for a small number of people, muscle pain can be a side effect of statins. Be sure to tell your doctor if you experience this.)

National Institute of Diabetes and Digestive and Kidney Disorders; National Heart, Lung, and Blood Disorders.
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